7 Subtle Signs of Menopause People Often Miss

Menopause refers to the period when menstruating people stop getting their period, which generally signals the end of the reproductive years. For most people, this happens between the ages of 45 and 55, but it varies from individual to individual.

You’ve probably heard of some of the common symptoms of menopause, such as hot flashes and weight gain, but there are a number of other symptoms to signal this transition that you may not be aware of.

“Perimenopause can actually start up to a full decade before the onset of menopause, with the most obvious sign of perimenopause being irregular menstrual patterns,” said Dr. Monica GroverOB-GYN and senior physician at VSPOT. “As a result, some early signs of menopause may be missed since (people are) still in the confusing and erratic state of menstrual patterns around this time.”

Here are a few signs you may not immediately recognize as perimenopause or menopause:

Decreased libido

Fluctuating hormone levels can contribute to a reduced sex drive,” said Dr. Anat Sapan, board-certified OB-GYN and menopause expert. “This is mistakenly attributed to a change in relationship problems, fatigue or other factors, leading to the overlooking of decreased libido as a symptom of peri/menopause.”

According to Dr. Catherine Hansenan OB-GYN and a menopause expert know Pandia health, there are no approved, highly effective prescriptions for the treatment of decreased libido. That said, a conversation with a provider trained in sexual health is important for guidance at this stage in life.

Vaginal dryness

It may become apparent that it is itchier down there than it used to be.

“During menopause, reduced estrogen can cause vaginal and vulval tissue to become thin and more susceptible to irritation and inflammation,” Grover said. “These symptoms may initially be diagnosed as bacterial or fungal vaginitis, but cultures may continue to be negative.”

Dr. Jaime SeemanThe OB-GYN and host of the “Fit and Fabulous” podcast, added that this vaginal dryness can cause pain with sexual activity and more frequent urinary tract infections, which is something you’ll want to monitor and talk to your doctor about.

Soreness in the chest

While those who are menstruating may experience breast tenderness, this is also a symptom of menopause.

Many people will complain of increased breast tenderness—or even just very sore nipples—when they reach that point in their early to mid-40s when their hormones fluctuate and they are in perimenopause,” said Dr. Shieva Ghofrany OB-GYN and expert at Perry.

Ghofrany recommended trying some lifestyle changes, such as reducing caffeine intake and limiting consumption of high-sodium foods, to see if that helps relieve some of the soreness. Additionally, always be sure you are up to date on your mammograms and see your provider, especially if the pain persists or is more one-sided.

Sleep disorders

You already can have insomnia or difficulty sleeping, but if this occurs later in life, it may be a sign of menopause.

Hormonal changes can lead to disturbances in sleep patterns such as difficulty falling asleep or staying asleep,” Sapan said. “Sleep problems are often attributed to stress, aging or lifestyle factors,” so many people often dismiss this particular symptom.

Hansen added that these sleep disturbances can also occur at this time in your life, when there are usually more racing thoughts about increased stressors, whether it’s looking after teenagers, empty-nesting, caring for sick parents or dealing with professional commitments.


Dizziness is another common symptom of menopause that is often overlooked.

“You may experience dizziness during perimenopause and menopause because the hormonal changes that take place affect the production of insulin, which can make it difficult for your body to maintain blood sugar stability,” Grover said.

If the dizziness persists and is causing disruption in your daily life, you should see your doctor to discuss treatment options and rule out any underlying conditions.

Mood swings

Almost everyone experiences ups and downs during their life, but this can be more noticeable during menopause, as it is for some when they are menstruating.

“MMenopause can cause hormonal fluctuations, leading to mood swings,” said Sapan. “These emotional changes are often misinterpreted as other factors such as stress, work or personal relationships, causing them to be overlooked as a symptom of peri/menopause.”

These mood swings may be manageable with therapy or other coping strategies alone. For more severe mood swings, however, you may consider medication.

Increased urge to urinate

While an increased urge to urinate can be a sign of other health problems like diabetes, it can also be a symptom of menopause.

“The lack of estrogen to the vagina/vulva and bladder often makes the bladder more susceptible to the ‘urgency symptoms’ associated with bladder irritation rather than a urinary tract infection” said Ghofrany. “Common triggers are foods/drinks that are more acidic, like caffeine in coffee/tea, alcohol, citrus foods and tomatoes.”

That said, you’ll always want to see your provider to make sure there’s nothing pushing on your bladder (like an ovarian cyst or uterine fibroid), which Ghofrany said can occasionally cause the same symptoms.

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